Shonberg - Chicago Dentist | Chicago Prosthodontist | Chicago Dental Implants

A prosthodontist is a dentist recognized by the American Dental Association and by state licensing authorities as a specialist in the restoration and replacement of teeth, with emphasis on both comfortable function and attractive appearance.

Prosthodontics is one of 8 specialties recognized by the American Dental Association. These are: (1) oral and maxillofacial surgery (tooth extractions and other surgery, including dental implants), (2) orthodontics (braces), (3) periodontics (gum treatment and surgery, and also dental implant surgery), (4) endodontics (root canal treatment), (5) pedodontics (children's dentistry), (6) prosthodontics (restoration and replacement of teeth), (7) oral pathology (microscopic examination of oral tissues), and (8) public health dentistry (the study of dental disease from a population perspective).

Dentists undertake prosthodontic training programs after they finish their basic dental degree (DDS or DMD), and they train for what is now a minimum of three years. The focus of training is on patients with complex dental needs.

What is 'board certification?'

'Board-certified' indicates successful completion of a comprehensive examination after completing an accredited specialty training program. The examination consists of a written component and a clinical component. During the clinical component, documented treatment of various types of complex care is presented to a board of examiners, and defended. In the specialty of prosthodontics, the American Board of Prosthodontics administers the examination. The Board consists of prosthodontists from across the country who are recognized in the field, and who are elected for specified terms by the Diplomates of the Board. As an alternative to examination by the American Board of Prosthodontics, some states administer their own board examinations.

After completion of the board certification process, the dentist becomes a Diplomate of the Board. Dr. Shonberg became a Diplomate of the American Board of Prosthodontics in June of 2000.

How is a prosthodontic practice like a general dentistry practice?

Our prosthodontic practice is similar to a general dental practice in many ways. For example, our staff includes two dental hygienists that perform preventive teeth cleaning (prophylaxis). In addition, many of our patients' needs fall into the category of "every-day dentistry."

A dentist with specialty training in prosthodontics also has the expertise to treat patients with complex treatment needs. Therefore, our practice also includes many patients who have had in the past, or who currently have, complex treatment requirements.

I have never liked wearing a lower denture. They don't stay tight like the upper ones. What are my options?

The stability and retention of a lower denture depends upon the adaptability of the patient, and the condition of the mouth. Patients differ markedly from one another in the amount of tissue remaining to support and stabilize a lower denture.

Research indicates that patients generally function better when a lower denture is stabilized with at least two dental implants. A tooth replacement (dental prosthesis) stabilized by two implants, and removable by the patient, is called an implant "overdenture." There are two advantages to this approach: (1) the dental implants can be fitted with an attachment that works like a "snap" that will hold the denture in position and (2) dental implants prevent the jaw bone from shrinking as rapidly.

A panel of experts recently concluded that, according to currently available data, the two-implant overdenture should be the new standard of care for patients who have no lower teeth remaining.

Is it always necessary to replace a single missing tooth?

Replacing a missing tooth is usually the correct course of action. This is because loss of a tooth frequently causes adjacent and opposite teeth to change position. However, this does not always occur. The last tooth in the upper or lower arch, left or right side, may remain unreplaced if there is no tooth opposite. These teeth, which have no tooth behind them, are usually the second molars. In addition, third molars, or "wisdom teeth," if present, typically do not need to be replaced.

Over the years, I have lost all my back molars. How big a problem is this, and what are my options?

In most cases, multiple missing back teeth should be replaced. Some patients can function with fewer than the normal complement of teeth, as long as the bite relationship can be kept stable. Even with a stable bite relationship, a "shortened dental arch" may compromise a patient's ability to chew. The options for restoring a shortened dental arch are replacement teeth supported by dental implants, and removable partial dentures.

What is "cosmetic dentistry?"

The American Dental Association does not currently recognize a specialty called cosmetic dentistry. However, there has been a considerable increase in the organized knowledge of what constitutes a pleasing smile, with a parallel development of materials and techniques to achieve esthetic goals.

Can you show me a personalized example of how my smile can look, before I choose to proceed with treatment?

In most cases, Yes. First, we determine the kind of changes that would be beneficial to your appearance. Changes may involve tooth color, shape, or both. You probably have your own ideas, but we can also make suggestions. Once we agree on the objectives, we make plaster models that show the details of your teeth. Then, using wax, we alter these models according to the agreed-upon esthetic goals. This is called a diagnostic wax-up. In some instances, this idealized model can be used to make a simulation that can actually be placed in the mouth. Even when this is not possible, this simulation is available for your inspection.

Adding tooth-colored resin material directly to the teeth is another way to preview results. This is like "bonding," except that the steps used to fix the resin to the teeth are omitted. This means that the resin material can be removed at the end of the appointment. Before the resin material is removed, a digital photograph can be made for you to evaluate at your leisure.

Computers can also be used to preview results, but computer simulations can be misleading. WIthout three-dimensional models, it may be hard to know whether a change that looks good on a computer monitor can actually be achieved in the mouth.

Do I need to take antibiotics before having my teeth cleaned, and before other dental procedures?

A dental procedure that causes even minor bleeding may cause a transient "bacteremia," a term which means "bacteria in the blood stream." This bacteremia may result in bacterial colonization of prosthetic joints or heart valves. A single dose of the appropriate antibiotic, taken one hour prior to the dental procedure, is thought to greatly reduce the quantity of bacteria in the blood stream.

However, the risks and benefits of all medications must be carefully weighed. Now, there are fewer conditions for which pre-treatment antibiotics are recommended.

According to the American Heart Association, conditions no longer needing antibiotic pre-medication are mitral valve prolapse, rheumatic heart disease, bicuspid valve heart disease, calcified aortic stenosis, and congenital heart conditions such as hypertrophic cardiomyopathy, ventricular septal defect, and atrial septal defect.

Patients still needing to pre-medicate are those with prosthetic heart valves, previous bacterial endocarditis, and certain types of congenital heart disease, such as: unrepaired cyanotic disease, with or without palliative shunts and conduits, congenital heart disease completely repaired with prosthetic materials or devices, repaired congenital heart disease with residual defects at, or adjacent to, the site of a prosthetic patch or device, and cardiac transplantation recipients with cardiac valvular diease.

If there is any doubt in a particular case, consultation with an internist or cardiologist is mandatory prior to any dental treatment, even routine dental prophylaxis (teeth cleaning).